Tubular apocrine adenoma of the eyelid - A case report and literature review

Glands of Moll: history, current knowledge and their role in ocular surface homeostasis and disease

Over the last 20 years, research into the Meibomian glands of the eyelids has increased exponentially and is now widely recognized as a field of research. It is all the more astonishing that knowledge about another type of gland in the eyelids, the Moll glands or ciliary glands, has almost stagnated and there has been little to almost no progress, even though this type of gland as a whole takes up a relatively large volume in the upper and lower eyelids. There is not much information about the namesake Moll or the function of the glands although these are listed in nearly every textbook of anatomy, histology and ophthalmology. For this reason, we set out to compile the existing knowledge about the Moll glands of the eyelids in order to create a basis for follow-up studies and to stimulate research into this type of gland. In our literature research, we went back to the middle of the 19th century and made contact with a descendant of the Moll family and illustrate their relevance for the present. The structure of the secretory part of the Moll glands is very well described, a number of secretory products are known, but the current state of research allows only very rough speculations about their function. The overview provides numerous interesting insights, which, however, raise more questions than they provide answers.

Recurrent ulcerative tubular apocrine adenoma of the eyelid mimicking eyelid malignancy: A case report and literature review

INTRODUCTION

The eyelid is a common site for cutaneous tumors; however, tubular apocrine adenoma is a rare presentation. The clinical presentation is variable and surgical excision is effective with low risk for recurrence.

PRESENTATION OF CASE

We report a 40-year-old female with recurrent tubular apocrine adenoma of eyelid mimicking eyelid malignancy. Diagnostic incisional biopsy demonstrated dermal benign tubular-like proliferations lined by bilayer of apocrine epithelium within a background of hyalinized stroma.

DISCUSSION

Isolated tubular apocrine adenoma of the eyelid is rare with individual cases being found in the literature. Previously reported recurring apocrine eyelid tumors were involving older patients than our case and the recurrence occurred within 2-3 years.

CONCLUSION

Our case is unique as the patient was younger and the recurrence occurred after a longer period. Our report provides insight into the clinical features, histopathologic characteristics and treatment of tubular apocrine adenoma of the eyelid.

[Clinical diagnosis and treatment of 14 cases of scar cancer ulcer wound on head and face]

Objective

To analyze the clinical characteristics of scar cancer ulcer wound of head and face, and to investigate its diagnosis and treatment.

Methods

The clinical data of 14 patients with head and facial scar cancer ulcer wounds who met the selection criteria and admitted between January 2021 and March 2022 were retrospectively analyzed. There were 8 males and 6 females. The age of onset ranged from 21 to 81 years with an average age of 61.6 years. The incubation period ranged from 1 month to 70 years, with a median of 4 years. Site of the disease included 7 cases of head, 6 cases of maxillofacial region, and 1 case of neck region. Injury factors included trauma in 5 cases, scratch in 5 cases, scalding in 2 cases, burn in 1 case, and needle puncture in 1 case. Pathological results showed squamous cell carcinoma in 9 cases, basal cell carcinoma in 3 cases, sebaceous adenocarcinoma in 1 case, papillary sweat duct cystadenoma combined with tubular apocrine sweat gland adenoma in 1 case. There was 1 case of simple extensive tumor resection, 1 case of extensive tumor resection and skin grafting repair, 7 cases of extensive tumor resection and local flap repair, and 5 cases of extensive tumor resection and free flap repair.

Results

All the 14 patients were followed up 16-33 months (mean, 27.8 months). Two patients (14.29%) had scar cancer ulcer wound recurrence, of which 1 patient recurred at 2 years after 2 courses of postoperative chemotherapy, and was still alive after oral traditional Chinese medicine treatment. One patient relapsed at 1 year after operation and died after 2 courses of chemotherapy. One patient underwent extensive resection of the left eye and periocular tumor and the transfer and repair of the chimaeric muscle axial flap with the perforating branch of the descending branch of the left lateral circumflex femoral artery, but the incision healing was poor after operation, and healed well after anti-infection and debridement suture. The wounds of other patients with scar cancer ulcer did not recur, and the wounds healed well.

Conclusion

Scar cancer ulcer wound of the head and face is common in the middle-aged and elderly male, and the main pathological type is squamous cell carcinoma. Local extensive resection, skin grafting, or flap transfer repair are the main treatment methods. Early active treatment of wounds after various injuries to avoid scar repeated rupture and infection is the foundamental prevention of scar cancer.

Apocrine Cystadenoma of the Eyelid, a Rare Neoplasm: Expanded Immunohistologic Profile

An 83-year-old woman experienced the slow enlargement of a right lower eyelid mass. Histopathologic examination of the excised tissue showed a mucin-filled cystic tumor emanating from an apocrine bilayer that displayed bleb-like apocrine decapitation secretion. The outer flattened myoepithelial layer of the bilayer reacted with immunohistochemical stains for smooth muscle actin and calponin. In foci, the tumor exhibited a cribriform architecture with small pockets of mucin. Tumor cells were reactive for cytokeratin 7, Gross Cystic Disease Fluid Protein 15 (BRST-2), estrogen and progesterone receptors, androgen receptors, mammaglobin, epithelial membrane antigen, and GATA3. Ki67 showed a very low proliferation fraction. The lesion exemplifies the fourth instance of an eyelid apocrine cystadenoma in the literature.